Accelerate Would Healing with Supplements, Tapes and Massage

Last week I had a laparoscopy surgery, in my case they made three cuts of about 2 centimeters in my lower abdomen. The first thing I thought when seeing them was "can I help those heal"?

Turns out the answer is yes.

Disclaimer: discuss any action you want to take with your surgeon, they know best how to prevent and treat complications. This article is a 'note to self' on my part and not medical advice.

Summary

Always:

• Take care of the basics
  • Sleep well
  • Make sure you are not deficient in nutrients

For a few weeks:

• Use supplements that stimulate skin healing
  • Hydrolysed collagen 20-40g/day
  • Vitamin c 2-6g/day
  • Start immediately, continue for a few weeks
• Use specific anti-inflammatory supplements
  • Bromelain 1,000,000PU (~270GDU)/day
  • Grapeseed extract 15mg/day
  • Start 2 days post operatively, continue for a few weeks

For a few months:

• Keep the wounds moisturised and protected
  • Keep the wound clean and moisturised
  • Use skin tape for a few months
  • Use sunscreen for at least 18 months
• Massage the scar twice daily for 10 minutes
  • Starting after 2-3 weeks, continue for a few months

Take care of the basics

You don't clean your house when it's on fire. Start with the important stuff:

• Sleep 7-9 hours a night depending on your sleep need
• Make sure you are not deficient in nutrients

On the second note check common deficiencies like vitamin d and b12 regularly. I personally do check a panel of vitamins/minerals at least once a year.

During intense healing processes I like to take a high dose (and high quality) multivitamin in addition to my regular focus on high quality nutrition.

Collagen: building blocks for flexible skin

Collagen is a protein that amongst other things makes up the extracellular matrix of the skin. Read: the scaffold.

A randomised double-blind placebo-controlled trial in burn victims used a 45 gram dosage of bovine hydrolised collagen, which made it 3.7 times more likely they healed completely within 4 weeks.

A randomised double-blind placebo-controlled trial in pressure ulcer (bed sore) patients a 2x daily 10 gram dose of hydrolised collagen had a significant positive effect over 16 weeks.

Note that in higher dosages collagen can give you mild diarrhea, if that happens back off on the dose.

Vitamin c: needed by collagen

Vitamin C has a boosting effect on collagen synthesis. If you're taking collagen it makes sense to take vitamin c so it can be used optimally.

Personally, I like buying a pure vitamin c powder and dissolving it in water. It tastes nice. Dosage wise I personally use 2-6 grams per day (more in the beginning after the surgery, less later). For a good breakdown on dosing and other vitamin c effects, have a look at Dr Rhonda Pattrick's page on it.

Bromelain & grape seed extract

A randomised placebo-controlled trial using a proprietary supplement found a 17% improvement in wound healing. The researchers seem to hint that the supplement might work through anti-inflammatory properties.

The supplement contained some vague ingredients like "proprietary enzyme blend" but also some known factors:

• Calcium, potassium, vitamin c
• Bromelain 1,000,000PU (~270GDU)
  • Pineapple-extracted anzyme
• Grape seed extract 15mg/day
• Rutin 75mg/day
  • Flavanol

I was only able to obtain bromelain and grape seed extract. Honestly compared to the results of the collagen I'm not too worried about these (though I am taking them for a few weeks post-operation).

Keep the wound clean and moisturised

In the first 3 weeks it is important to keep the wound moisturised. This assumes it is not bleeding or infected.

Cleaning is best done with water and not with alcohol, which will harm the wound healing process. If you fear infection talk to your doctor.

In the 2016 Update on Postsurgical Scar Management the first note on postoperative interventions is:

In the early postoperative period, an optimal wound-healing environment must be maintained to allow for the best possible results. Prevention and control of infection remains the key to this process. This begins by creation of a moisture-rich environment for scar formation.

To achieve this they mention:

• Antibacterial cream (no thank you 🇪🇺)
• Petroleum jelly (vaseline)
• Silicone sheets

On Vaseline in particular:

Petroleum jelly ointments such as Vaseline (Unilever, Englewood Cliffs, NJ) applied three times daily for 1 to 3 weeks duration or nonadherent petroleum-impregnated gauze such as Xeroform (Kendall/Covidien, Mansfield, MA) placed daily for 1 to 3 weeks are excellent alternatives to maintain wound bed moisture

And on silicone sheets:

Ideally, they should be worn for at least 12 h/d for 3 to 4 months, making sure not to exceed a 6-month total treatment duration as this longer course may negatively affect healing.

Personally I opted for plasters that are similar to silicone sheets and used some surgical tape around them to prevent them from falling off while I move.

Use skin tape or paper tape

A selective quote from the above article (emphasis mine):

Paper tape, such as Micropore (3M, St. Paul, MN) tape or Steri-Strips (3M) ... prevent stretching of the wound by reducing tension on wound edges and minimizing shear forces ... preventing excessive soft tissue formation and thus reducing scar volume ... keeping the wound moist by minimizing the formation of scabs. Compared with silicone sheets, Micropore tape produces analogous results

With respects to dosage:

We recommend placement of paper tape for at least 6 weeks postoperatively.

Use sunscreen for at least 18 months

Surgical wounds take about 18 months to fully finish the healing process. According to Overview of Surgical Scar Prevention and Management, the tensile strength of a surgical incision wound is:

• 3% after one week
• 20% after 3 weeks
• 80% after 3 months
• ~18 months to finish the process of remodelling fully

Wounds are very sensitive to UV damage, quoting the "updates on" article:

sunscreen with recommended SPF (sun protection factor) of 30 for 12 to 18 months postoperative is essential in protection against damaging ultraviolet radiation and must be worn at all times when the patient is in sunlight

Massage the scar twice daily for 10 minutes

Massaging the scar works through "the degradation of excessive and nonpliable collagen". In other words, the healing process is imperfect and it's like using sandpaper on rough wood.

The researchers suggest:

beginning scar massage approximately 2 to 3 weeks postoperatively and performing twice daily 10-minute massages for a total duration of at least 6 weeks

It's essential to be gentle in this process, you don't want to cause new damage to the wound.